J Affect Disord. 2025 Nov 29:120787. doi: 10.1016/j.jad.2025.120787. Online ahead of print.
ABSTRACT
BACKGROUND: Increased mental health-related outpatient visits among adolescents have been reported worldwide.
AIMS: This study aimed to investigate the prevalence of anxiety symptoms in community-based samples in Zhejiang Province using a stratified cluster sampling method, and to describe the distribution of these symptoms across different grades.
METHODS: A total of 8287 students from grades 4 to 11 were recruited from representative schools in five cities. Participants completed the Screen for Child Anxiety-Related Emotional Disorders (SCARED) and a questionnaire on family environment. The survey was conducted in the schools from September 2021 to April 2023.
RESULTS: The overall prevalence of anxiety symptoms was 31.3 %. Rates of school phobia and social anxiety were higher in senior grades. Female sex and higher grade levels were associated with more symptoms. Multivariable logistic regression identified female sex, higher grade, greater finance expenditure on the child, chaotic family environment, a history of being left behind by migrant parents, parent neglect and overprotection as significant risk factors for anxiety. Better academic performance, a larger number of friends, and more time spent with the child were identified as protective factors.
CONCLUSION: This study revealed a high prevalence of anxiety symptoms among primary and secondary school students in Zhejiang Province. Notably, a significant positive correlation between school phobia and senior grades was observed, which was not reported in previous studies in China or international literature, suggesting a shift in the developmental patterns of school-related anxiety.
PMID:41325810 | DOI:10.1016/j.jad.2025.120787
